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Effectiveness of dexamethasone iontophoresis for temporomandibular joint involvement in juvenile idiopathic arthritis.
- Source :
-
Arthritis care & research [Arthritis Care Res (Hoboken)] 2011 Nov; Vol. 63 (11), pp. 1511-6. - Publication Year :
- 2011
-
Abstract
- Objective: Temporomandibular joint (TMJ) involvement is common in juvenile idiopathic arthritis (JIA). Dexamethasone iontophoresis (DIP) uses low-grade electric currents for transdermal dexamethasone delivery into deeper anatomic structures. The purpose of this study was to assess the safety and effectiveness of DIP for the treatment of TMJ involvement in JIA, and to delineate variables that are associated with improvement after DIP.<br />Methods: Medical records of all JIA patients who underwent DIP for TMJ involvement at a larger tertiary pediatric rheumatology center from 1997-2011 were reviewed. DIP was performed using a standard protocol. The effectiveness of DIP was assessed by comparing the maximal interincisor opening (MIO(TMJ) ) and the maximal lateral excursion (MLE(TMJ) ) before and after treatment.<br />Results: Twenty-eight patients (ages 2-21 years) who received an average of 8 DIP treatment sessions per involved TMJ were included in the analysis. Statistically significant improvement in the median MIO(TMJ) (P < 0.0001) was observed in 68%. The median MLE(TMJ) (P = 0.03) improved in 69%, and resolution of TMJ pain occurred in 73% of the patients who had TMJ pain at baseline. Side effects of DIP were transient site erythema (86%), skin blister (4%), and metallic taste (4%). Improvement in TMJ range of motion from DIP is associated with lower MIO(TMJ) , lower MLE(TMJ) , and absence of TMJ crepitus at baseline.<br />Conclusion: In this pilot study, DIP appeared to be an effective and safe initial treatment of TMJ involvement in JIA, especially among patients with decreased TMJ measurements. Prospective controlled studies are needed.<br /> (Copyright © 2011 by the American College of Rheumatology.)
- Subjects :
- Administration, Cutaneous
Adolescent
Anti-Inflammatory Agents adverse effects
Arthralgia drug therapy
Arthralgia physiopathology
Arthritis, Juvenile diagnosis
Arthritis, Juvenile physiopathology
Biomechanical Phenomena
Child
Child, Preschool
Dexamethasone adverse effects
Facial Pain drug therapy
Facial Pain physiopathology
Female
Glucocorticoids adverse effects
Hospitals, Pediatric
Humans
Male
Ohio
Pain Measurement
Pilot Projects
Range of Motion, Articular
Recovery of Function
Retrospective Studies
Temporomandibular Joint physiopathology
Temporomandibular Joint Disorders diagnosis
Temporomandibular Joint Disorders physiopathology
Time Factors
Treatment Outcome
Young Adult
Anti-Inflammatory Agents administration & dosage
Arthritis, Juvenile drug therapy
Dexamethasone administration & dosage
Glucocorticoids administration & dosage
Iontophoresis adverse effects
Temporomandibular Joint drug effects
Temporomandibular Joint Disorders drug therapy
Subjects
Details
- Language :
- English
- ISSN :
- 2151-4658
- Volume :
- 63
- Issue :
- 11
- Database :
- MEDLINE
- Journal :
- Arthritis care & research
- Publication Type :
- Academic Journal
- Accession number :
- 22034112
- Full Text :
- https://doi.org/10.1002/acr.20600